Amanda is a children's nurse, having worked on pediatric wards and in the community supporting children with complex health needs, although over ten years of her nursing career have been in neonatal care, where she is further qualified in specialty (QiS). She trained and volunteered in breastfeeding peer support two years into her nursing career, ultimately sitting the exam to become an IBCLC to ensure that the families within neonatal care had access to an infant feeding specialist familiar with their journey. Amanda has since further specialized in Neonatal Homecare, is a Nurse Practitioner in restrictive lingual frenulum, and has worked as an Infant Feeding Lead for a regional surgical NICU and SCBU, as well as a regional Infant Feeding Advisor to ten neonatal units across a regional network. She has recently been appointed to the Board of Trustees for the Lactation Consultants of Great Britain (LCGB), where she is the Neonatal Lead.
While approximately 80% of UK mothers initiate breastfeeding, by 3-4 months, just 15% of infants receive any breastmilk. Despite the low rates of breastfeeding nationally, in 2021-22, 64% of the NICU graduates in our unit were discharged receiving breastmilk. One possible reason for the higher rates of breastfeeding in this population may be our innovative home NGT feeding programme.
In order to hasten discharge from NICU, many mothers feel under pressure to introduce bottles to meet “full oral feeding” criteria. The home nasogastric tube (NGT) feeding programme focusses on the infant’s and family’s needs, without rushing the infant towards full oral feeding, which some are not yet ready for. In this way, all oral feeds can be at the breast, with NGT feeds as required for supplementation. We aim to reduce unnecessary days in hospital, reduce readmissions post-discharge, keep families close to their infants, and embrace the integration of families as essential members of the neonatal care team.
This presentation will discuss the practicalities of designing a discharge pathway that optimises parental confidence and ensures competence with home administration of NGT feeds. It will also discuss how to predict which infants are ideal candidates for short-term home NGT feeding, and how to transition to direct breastfeeding. Finally, the presentation will present a case for home NGT feeding as an intervention to protect the mother’s breastfeeding goals, optimise clinical outcomes for infants, and improve the experience of neonatal care for families.
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